BIP Spring 2025

3 Right to Quality Care (Article II) —mental health initiatives

only highlights the importance of transparency but also sets a standard for how PBMs should operate to serve their clients’ best interests.” 2 Right to Healthcare Education (Article VI) — healthcare literacy Many studies show the majority of Americans struggle with healthcare literacy — and NABIP members are not exempt. “NABIP members can be better stewards of teaching the language of healthcare so that they can educate their clients and help them become more fluent in all aspects of healthcare,” says Gaunya. To further this pursuit, the Delta Force partnered with the late Marshall Allen, an advocate for healthcare consumer education, on a series of 16 educational videos he developed to empower individuals with the knowledge needed to navigate the healthcare system effectively. These resources are now in the hands of NABIP’s Education Foundation, with plans to expand the reach to consumers nationwide. “We believe that by starting with our members and expanding outward, we can create a ripple effect that ultimately leads to more informed healthcare consumers who get the highest quality at the lowest possible price,” Gaunya says.

A standout accomplishment in 2024 was the Delta Force’s advocacy for integrated behavioral health (IBH) initiatives. When the federal government introduced its IBH model plan for Medicare and Medicaid, the Delta Force played a pivotal role in evaluating and supporting the effort. “We wanted to ensure that this strategy addressed immediate needs and served as a blueprint for the private market,” Gaunya says. The Delta Force’s support for IBH reflects its commitment to improving mental and behavioral health access and integration across the healthcare ecosystem. By advocating for scalable solutions, the Delta Force intends to create a lasting impact on both public and private healthcare consumers. Next steps Looking ahead, the Delta Force is exploring ways to expand access to primary care, including direct primary care (DPC), by addressing its classification as an insurance product under IRS regulations. This product classification prevents DPC from being considered an eligible

medical expense for tax-preferred accounts like FSAs and HSAs. There are more than 60 million people with more than $60 billion in savings in these types of accounts — funds that could be invested in primary care like DPC. To tackle this, the Delta Force is working with leaders in both houses of Congress. The Delta Force is monitoring relevant legislation with the potential to ease the burden by broadening eligibility, eliminating restrictions tied to high-deductible plans, doubling contribution limits and recognizing DPC as a qualified medical expense that improves access to primary care. “The system we’re living

in now has a crumbling foundation. It serves the policymakers, not the consumer. Our goal is to

change that,” says Gaunya. “Our job is to look at the existing infrastructure and say, ‘How do we build a smart healthcare house?’ Because the one we’re living in now doesn’t serve the people.”

Vladimir Ivankin / iStock

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